11. Communicating with the Dental Laboratory Flashcards
Dentist Guidelines
n Provide ____ instructions to laboratory (and retain duplicate)
nClearly written and understandable
nDetail work to be performed
nDescribe materials to use n Coloration
n Written description, photograph, drawing, shade tab
written
Dentist Guidelines
n Provide accurate:
n ____
n Casts
nOcclusal ____ nMounted casts (where indicated)
n Dentist should identify crown ____ (where indicated)
n Dentist should properly clean and ____ all items before sending
impressions
registrations
margins
disinfect
Technician Guidelines
nTechnician should follow guidelines of written instructions from dentist
nTechnician should ____ written instructions
nWritten instruction forms provided by the lab should include ample ____ for dentists written instruction
nTechnician should return case to check ____, if possible inaccuracy
retain
space
mounting
Technician Guidelines
nTechnician should match ____ indicated
nTechnician should return work in a timely manner
nTechnician should follow ____ control standards
shade
infection
Work Authorization
n General description of restoration to be made n Material specification n Desired occlusal scheme n Location of \_\_\_\_ n Specify \_\_\_\_ or metal contacts n Diagnostic \_\_\_\_ helpful for scheme n \_\_\_\_ design for fixed dental prosthesis n Cast vs. post-ceramic soldered n \_\_\_\_ and substructure design n Including \_\_\_\_ for tissue contact
occlusal contacts porcelain wax-up connector pontic material
Work Authorization
n Substructure design for metal ceramic restorations
n Indicate if want to see entire ____ before cutback n Shade selection
n ____ of tooth helpful
n Custom shade tab
n ____ shade analysis
n Photograph
n Technician may see patient with dentist (where ____)
n Date of next scheduled patient ____ and stage of ____ required
wax up diagram digital lawful appointment completion
Work Authorization
n Shade distribution chart must be adequate to include details nSubtle \_\_\_\_ differences n \_\_\_\_ n \_\_\_\_ n \_\_\_\_
shade
hypocalcification
translucency
stains
Work Authorization n Additional information nDiagnostic waxing nCasts of provisional restorations n \_\_\_\_ n \_\_\_\_ edge position n \_\_\_\_ form nDigital images
midlines
incisal
coronal
Problems n Most common problems seen by dentist nPoor \_\_\_\_ adaptation nPoor \_\_\_\_ nPoor \_\_\_\_ contour n Overcontouring of cervical 1/3 nHaphazard \_\_\_\_ and substructure design
marginal
occlusion
axial
pontic
Problems n Most common problems seen by technician nInadequate \_\_\_\_ reduction n Esp. \_\_\_\_ n mystery \_\_\_\_ n Improper \_\_\_\_ nVagueness in \_\_\_\_ communication
tooth cervical 1/3 margins articulation color
Interim Cementation
n Sometimes recommended so patient and dentist could assess appearance and ____ over time
n Manage cautiously
nOften difficult to ____
n May mix interim cement with ____
n May apply only at ____
nMay loosen during function. If loosens:
n Uncomfortable/embarrassing for patient
n May result in ____ if patient does not
return (especially if an abutment loosens)
n Patient needs instructions regarding objectives, duration and importance of returning
function remove petrolatum margins caries
Interim Cements Main Clinic nTemp Bond NE (Kerr) nFynal (Denstply) in ADCC (honors) n\_\_\_\_ final cement nDycal (Dentsply) nIRM (Dentsply) nDurelon (3M/ESPE) n May use as \_\_\_\_ interim cement 2018
ZOE
long term
Introduction
nDefinitive cementation does not receive same attention to detail as other aspects of restorative dentistry
nCareless luting selection ____ discrepancies nImproper ____
nMay require ____ restoration off and remaking
margin
occlusion
cutting
Choice of Luting Agent
n Depends on ____ casting or adhesively bonded restoration
n Ex. Ceramic inlay or resin bonded FDP
n (1)Traditional water-based dental cements n Use for ____ and FDPs
n Not used where ____ is needed
n (2)Adhesive resins
n Necessary for some restorations
n ____ sensitive and can be difficult to use (newer self-etch formulations easier)
n Long term data justifying more general use with ____ limited
conventional
cast crowns
adhesion
technique
conventional castings
Dental Cements
n Most luting agents traditionally used for cast restorations are ____
n Susceptible to acid attack making them somewhat soluble in ____ fluids
n In vitro studies show this is independent of marginal ____ (up to certain critical value)
n Dissolution is mechanism in cement ____ (not disintegration)
cements
oral
width
erosion
(1)Zinc Phosphate Cement n Still used for \_\_\_\_ restorations n Adequate strength n Acceptable \_\_\_\_ thickness (25um) n Reasonable working time n Excess material easily \_\_\_\_ n \_\_\_\_ effects on pulp are well documented (phosphoric acid) n Take normal precautions n Not used when preparation is too close to \_\_\_\_
cast film removed toxic pulp
(1)Zn Phosphate Cement
Choice of Luting Agent
nDespite limited biocompatibility due to pulp irritation > long history of ____ (important!)
n Cavity ____ may protect pulp with no decreased retention
nRemains good option for luting restorations on otherwise normal, conservatively prepared teeth
nCrowns displayed increased resistance to ____ on preparations with minimal resistance form
success
varnish
dislodgement
(1)Zinc Phosphate Cement
n Examples
n____ (Mission)**
zinc cement
(2)Zinc Polycarboxylate Cement
n Biocompatible
n Large polyacrylic acid molecule does ____ penetrate
dentinal tubules
n Exhibits ____ to tooth
n Due to ____ chelation
n No adhesion to ____
n High viscosity makes mixing ____
n May use encapsulated products
n Claims of ____ long term retention
n May adversely change properties by adjusting powder/liquid ____
n ____ Powder/liquid ratio ____ solubility
n Also improved with encapsulated products
not
adhesion
calcium
castings
difficult inferior ratio decrease increase
(2)Zinc Polycarboxylate Cement
n Working time much shorter than ____
n 2.5 min compared to 5 min
n Problem with ____ units
n Residual cement more difficult to ____ than Zn phosphate
n Some studies show less ____ than Zn phosphate
n Limit to restorations with good retention and resistance
form where minimal ____ irritation is wanted
n May use as a base and to block out minor ____ on vital teeth
n Chemical interaction with ____
n Contraindicated cementing crowns on Ti abutments
Zn phosphate multiple remove retention pulp undercuts titanium (Ti)
(2)Zinc Polycarboxylate Cement
Choice of Luting Agent
nRecommended on retentive preparations when minimal pulp irritation is important
nEx. Children with ____ pulp chambers
large
(2)Zinc Polycarboxylate Cement
n Examples
n ____ (3M/ESPE)**
**Main clinic: Use for ____ cementation
durelon
temporary
(3)Glass Ionomer Cement
n Adheres to enamel and \_\_\_\_ n Exhibits good \_\_\_\_ n Releases \_\_\_\_ n May have anticariogenic effect n Has NOT been documented \_\_\_\_! n Set exhibits \_\_\_\_ n Advantageous with porcelain labial \_\_\_\_
n Mechanical properties ____ to zinc
phosphate and polycarboxylate cements
n ____ appearance when set
n Difficult to distinguish between ____ caries
n Difficult to distinguish ____
dentin biocompatibility clinically translucency margins
superior
radiolucent
recurrent
overhang
(3)Glass Ionomer Cement
n Susceptible to moisture ____ during setting
n protect with foil, resin coat or band of cement undisturbed for ____ minutes
nWater changes setting reaction resulting in water absorption > ____
nDo not ____ during initial setting
n Newer resin modified ____ ionomers are less susceptible to early moisture exposure
contamination 10 erosion dessicate less
(3)Glass Ionomer Cement
n Post operative ____ reports have not been demonstrated in clinical trials
nLittle ____ response found histologically
n May be due to dessication or ____
contamination
nEvaluate technique if sensitivity
nResin modified and self-adhesive resins show less post operative ____
nDesensitizing agent may prevent ____
n may decrease ____
sensitivity pulpal bacterial sensitivity sensitivty retention
(3)Glass Ionomer Cement
Choice of Luting Agent
nPopular cement for luting ____ restorations
nGood working properties
nMore ____ than zinc phosphate
nSets more ____ than zinc phosphate nEasily ____
casting
translucent
rapidly
mixed
